Congenital mesenteric defects and unexpected death-a rare finding at autopsy

Pediatric and Developmental Pathology : the Official Journal of the Society for Pediatric Pathology and the Paediatric Pathology Society
Roger W Byard, Regula Wick

Abstract

Gastrointestinal causes of sudden and/or unexpected death in the young are uncommon and only rarely involve congenital anomalies of the mesentery. Two cases are reported of unexpected deaths following herniation of intestine through congenital mesenteric defects to illustrate the forensic issues that may arise. Case 1 involves a 2.5-year-old girl who collapsed on arrival to hospital following 18 hours of fever and apparently mildly nonspecific symptoms. Resuscitation was unsuccessful, and at autopsy a segment of gangrenous small intestine was found that had herniated through a congenital mesenteric defect. Case 2 involves a 23-year-old woman with a past history of severe mental and physical disabilities who was found dead in her bed. She had a recent history of mild diarrhea and vomiting, but had not appeared particularly ill. At autopsy the peritoneal cavity was filled with a very dilated and obstructed colon as a result of herniation of a segment of sigmoid colon through a distal small intestinal mesenteric defect. These cases demonstrate that symptoms and signs of intestinal ischemia may not be clearly manifested in early childhood and that developmental delay may also result in older individuals presenting in a nonspecific ...Continue Reading

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Citations

Nov 15, 2011·Surgery Today·Daisuke HashimotoHideo Baba
Jan 20, 2010·Forensic Science, Medicine, and Pathology·Jonathon Herbst, Neil E I Langlois
Jan 1, 2013·Journal of Surgical Case Reports·Hideki KatagiriJunji Machi
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Aug 11, 2011·Journal of Forensic Sciences·Rexson Tse, Roger W Byard
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Apr 30, 2013·International Journal of Surgery Case Reports·Hager Aref, Bandar Felemban
Dec 2, 2014·International Journal of Surgery Case Reports·Kaundinya Kiran BharatamRaja Raghavendra Reddy
Sep 7, 2016·Indian Journal of Pediatrics·Bijal M ShrivastavaFarhana Bakshi
Apr 24, 2012·Journal of Forensic and Legal Medicine·Roger W Byard
Feb 4, 2016·The Medico-legal Journal·Ritesh G MenezesKhushboo Chawla
Nov 17, 2017·Medicine, Science, and the Law·Ritesh G MenezesMohammed Madadin

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